Health care

(HOST) A health care reform deal was reached between the legislature and the governor this spring. But commentator Allen Gilbert says that there's broad recognition that we're still not where we need to be.

(GILBERT) We won't hear much about health care in state and local elections this year. That's because the issue has been "taken off the table." That's a euphemism meaning that a compromise was reached that nobody really liked. There will be greater access to basic health care, but the overall system will remain much the same. Speaker of the House Gaye Symington told the Bennington Banner last month, "It's hard to make everyone happy. In fact, it's probably impossible. But the one thing everyone involved could agree on is, where we are is not OK."

So Democrats and Republicans went somewhere else. But few people - including the legislators themselves - liked where they ended up.

As a state, and as a nation, our struggle to provide decent health care to all citizens goes back decades. President Harry Truman advocated universal health care coverage. That was in 1945. Medicare and Medicaid were eventually developed in the 1960s for the elderly and the poor. But these programs do little for the vast population that remains and may make private health insurance more expensive because of cost shifts.

People live in fear of losing their coverage if they lose their jobs. Even if you have insurance, dealing with a mis-coded bill can take weeks. In the meantime, you look at the charge you'd have to pay if you didn't have insurance, and you realize that you couldn't afford the procedure and would probably do without, even though the procedure might be life saving.

It's doubtful that we can solve this problem without reaching broad agreement that we're all entitled to decent health care. We don't agree on that now. Contrast this with our attitude about public education. We'd never accept a school system that excluded children whose parents didn't have jobs, had jobs but didn't earn much money, or decided they'd do without education for their kids. But that's the system that we have for health care. And somehow we rationalize that it's acceptable.

I saw a small ray of hope earlier this summer when a Citizens' Health Care Working Group concluded that the government should guarantee a core set of health benefits for all Americans within six years, even if it means raising taxes. The group of fifteen citizens is a nonpartisan advisory panel created by Congress. The idea behind creating the group was that maybe citizens could break the log-jam of inaction on health care. A sponsor of the bill said, "The hope is to see if a citizen-driven process can provide a general roadmap."

Now that the report has been submitted, the legislation requires five different congressional committees to hold hearings. The President must comment on the report as well.

A cynic would say that this is all window-dressing. But at some point political leaders will have to embrace citizens' calls for universal coverage. They will have to do more than move somewhere else from where we are now. Let's hope that day is sooner rather than later.

Allen Gilbert is a former journalist, teacher, and consultant currently serving as executive director of the ACLU of Vermont. He has a longtime interest in public policy issues.